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General NPI Number Information
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NPI Number | 1811249691
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Entity Type | Individual
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Provider Name | SARAH E.W. KOON LMHC, LCAC, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 805 LEONARD ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1138
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Country | US
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Telephone | 616-451-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 105 ROLLINGROCK DR
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City | ROCKFORD
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State | MI
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Zip | 49341-1197
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Country | US
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Telephone | 517-448-0228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A9927
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A9927
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6401016578
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 87001563A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3072-A
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License Number State | NC
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